Individual provider Active NPI

Joanna Lynn Weitzel, PHARMD

  • Pharmacist
  • Springfield, MO
National Provider Identifier
1760086961
Registry record updated Nov 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2000172851 Issued in MO
Practice address
3030 S Campbell Ave
Springfield, MO 65807-4909
Phone
(417) 881-1494
NPI assigned
Nov 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2000172851 MO Primary

Addresses

Primary practice location

3030 S Campbell Ave
Springfield, MO 65807-4909

Mailing address

3030 S Campbell Ave
Springfield, MO 65807-4909
Phone (417) 881-1494

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Rx03897@CVSHealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
2000172851MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606521600000",
    "number": "1760086961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 S CAMPBELL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074909",
            "telephone_number": "417-881-1494",
            "fax_number": "417-881-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 S CAMPBELL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074909",
            "telephone_number": "417-881-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZEL",
        "first_name": "JOANNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-28",
        "last_updated": "2020-11-28",
        "certification_date": "2020-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2000172851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Rx03897@CVSHealth.com",
            "affiliation": "N",
            "address_1": "3030 S Campbell Ave",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658074909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.